06.19.08

Medical update

Posted in Day-to-day, Medical at 1:29 pm by ACR&S

Piglet, the little incisor-less piggy we took in at the beginning of April, had her remaining incisors pulled on the 17th. There was absolutely no sign of regrowth from the missing incisors in the month and a half we had her, so our vet was convinced that the tooth buds were dead, and that pulling the two remaining teeth would be easier on her than having monthly anesthesia to trim the teeth (without their uppers to grind against, the incisors would grow and grow until they impacted her upper gums).

The surgery was risky because Piglet has been in such poor body condition. She was so thin when she came to us, it took forever to get her stabilized above 700g, which is the minimum weight the vet felt would allow her to survive an extended anesthesia. There was a good chance that after all this effort, we’d lose her.

Fortunately, just a couple hours after she went in, I got the call that her surgery went very well. She was awake and taking syringed Critical Care very quickly afterwards, which was excellent. Here’s a picture of the extracted teeth. The blue lines roughly indicate where the gumline was – piggy teeth curve WAY down into the jaw! They are laying against the printed boxes on a GL weight record, for size reference.

Unfortunately, as soon as we picked her up we noticed something else was wrong: her right eye was dry looking and slightly swollen. It shortly developed a reddish spot. We traipsed back into the vet and he thinks that her eye rubbed against something during surgery or recovery. She had a definite corneal abrasion and would have to be on antibiotic eye drops, in addition to the oral antibiotics and pain meds for the tooth extraction.

The vet\'s e-collarTo make matters worse, the eye was clearly bothering her, and she persisted in trying to scratch it with her hind leg. The vet had to fit her with an e-collar to prevent her from causing further damage. The only e-collar small enough was actually a bird collar. He cut the central opening larger to accommodate the larger neck of a piggy, but it was designed to be very wide and stiff to prevent a bird from removing it. Poor Piglet could hardly walk with it on.

I was concerned about having to use an e-collar – they are bad for pigs and rabbits, for several reasons. First and foremost, both species are coprophages and must eat their cecal droppings in order to complete their normal digestive cycle. With an e-collar, they cannot reach these nutrient-rich pellets, and may quite quickly develop digestive problems such as stasis, because without them digestion does not occur correctly. This is compounded if the e-collar interferes with normal eating, too. This one certainly did, as Piglet could not even lower her head to reach her bowl.

NOM NOM NOM

However, we really didn’t have many other options with Piglet. She absolutely had to have something between her eye and her feet. When we got her home, the first thing I did was take off her collar and give her a chance to eat while DKMS stood guard against eye scratching, and I tried to figure out some alternatives to the collar. I figured she would spend all her time scratching, or her gums would hurt too much to eat, and I’d have to re-collar and handfeed her. Boy was I wrong. She went after her bowl of mash like a buzzsaw, actually STANDING in it to lick it up against the far side of the bowl!

SO MAD

At the advice of the good people on Guinea Lynx, we were advised to construct a new e-collar out of interfacing, which is a stiff but flexible fabric material used in sewing. While she was eating, I made one up, and after she’d eaten her fill, I taped it on. She was NOT happy. But at least she could bend her head down, lie down, and reach her bowl, now.

She managed to keep the collar on all night, much to my surprise (these guys are often very inventive at getting a foot inside the neck hole and wiggling out of them). She’d definitely eaten some more mush overnight, too. I took the collar off for about an hour, and although she wasn’t thrilled about breakfast, I did see her eat several cecals and do quite a bit of grooming. She only scratched at her eye once, and it looks slightly less red and swollen, although still very dry. Maybe, if it’s better tonight, she can go a little longer without the collar!

The next few days will be critical for Piglet. We must keep her eye from getting infected, because an infection that close to the surgery in her mouth could spread quite easily and become fatal. We also have to make sure she keeps eating, as the antibiotics and surgery have compounded the eating problems she already had with missing teeth. If we can just get both of these issues resolved, we can work on getting her to eat more whole foods, and that will allow us to try to find a cagemate for her. The ultimate goal of her rescue was to allow this poor, lonely, malnourished girl to have a shot at a normal piggy life. At this point we just have to wait and see whether that will be possible.

Eye - day 3Update: This morning, here eye definitely looks a little better!

06.17.08

Vet school adventures

Posted in Humor, Medical at 12:30 am by ACR&S

Both branches of ACR&S – the main adoption branch in NC, and the Sanctuary branch in WI – are each fortunate to be located very close to a major vet school. Ever since ACR&S’ inception, I have loved vet schools and loved working with them on rescue projects whenever possible. This past week, ACR&S and the Wisconsin Guinea Pig Rescue (WGPR) collaborated with the vet school at UW-Madison on a opthalmology clinic for exotics. This was a unique opportunity both for the two rescues, as well as for the vet students who participated.

We were approached by one of the coordinators, asking if our guinea pigs and rabbits could donate their time for eye exams. Normally, these clinics involve laboratory animals, all of whom are young, healthy, and identical. The laboratory animals are typically bought just for the clinic, and then euthanized for use in the cadaver labs. By working with rescues, the vet school was able to avoid unnecessary euthanasia, as well as to give the students the rare chance to examine animals across the spectrum; old and young, health and with medical conditions.

Between ACR&S and WGPR, we were able to present the students with 12 guinea pigs and 7 rabbits to examine, ranging from 2-12 years in age. The guinea pigs ranged from healthy animals to those with such various conditions as pea eye, cataracts, and entropian eyelids. The rabbits included healthy eyes, conditions such as chalazions and cataracts, and eyes of different colors (pink and blue in addition to the normal dark brown!).

After the exam, one of the vet professors told us this was the first time some of these students had done an exam on guinea pigs. They just don’t have any opportunity for exotics clinics in the typical “track” of classes. The variety of eyes and conditions allowed the students to practice with a wide range of instruments and challenged them to make diagnoses rather than just observe healthy eyes. We also benefited – it would have been impossible for us to pay for specialty clinic opthalmology exams for 19 animals!

ACR&S was very grateful for this opportunity. All of these animals in our Sanctuary owe their lives to vets who have donated time and experience, and a few hours of non-invasive examination is the least we can do to help pay it back to the younger generation of vets. I love the idea that just maybe, working with a rescue will motivate a vet student to become involved in rescue later in life, or that seeing the differences in guinea pigs and rabbits will engage a student to become an exotics vet rather than taking the usual cat/dog track. In addition, it’s good to know that we saved the lives of 20 lab animals who would have otherwise have to have been used for this lab.

Most vet schools are eager to work with rescues, and the benefits are tangible. I strongly recommend such a partnership to any rescue.

Now on to the pictures! We weren’t able to take photos of the exams themselves, since eye exams are performed in the dark (obviously!), but I got a couple of interesting shots I wanted to share with you.

I’m often accused of driving a Tardis, and several folks were skeptical when I reported I would be carrying myself, the president of WIGPR, and 13 carriers in a Toyota Corolla. Well, here’s the proof:

Six crates… Nine crates… Eleven crates!

Crates..Crates..Crates

Plenty of room left over for the two crates from WIGPR, plus, I can still see out the mirror!

Crates

Roo was a little concerned about why he was in this box…

Roo

But most of the guinea pigs were more concerned with eating breakfast.

Fred & Aragorn

Here’s all the crates unloaded. 19 animals in 13 crates!

In the lab

A shot of the lab room, showing some of the interesting decor.

Lab animals

The school lobby.

Giraffe in the lobby

Random painting in the hallway of doctor parrots.

Doctor birds


Several people have asked me to post more about being in Wisconsin. I’m hesitant to use this as a personal blog – we have plenty to say about the animals without getting off topic.

Whoops

I will mention just a couple of things this time. First, we’ve had some bad weather up here recently: tornadoes, torrential rain, thunderstorms driving destructive winds and hail. The joke “nine months of winter, three months of bad weather” was not a joke this year. Fortunately, apart from one journey into the basement due to the local tornado alarm going off, I haven’t much been affected. I did get this shot of a mudslide about to come into my lane on the highway.

Other than that, the most other interesting thing I’ve seen up here is, apparently the local plumber is offering the deal of a lifetime: SEVEN houses on my street threw out toilets last week. I only captured five of them.

So yeah, that’s why I don’t post about Wisconsin, much.

04.25.08

Health updates

Posted in Day-to-day, Medical at 4:23 am by ACR&S

First, congratulations to our very own Dr Jhondra Funk-Keenan, long time volunteer and foster parent – she has won the 2008 Oxbow Veterinary Medicine Scholarship! We are very proud that Oxbow has formally recognized Jhondra’s skills and commitment to exotic animal medicine.


So a few health updates:

Blimpie went to the vet Monday for eye damage. He got a big piece of hay stuck in there (possibly as long as 12 hours before I saw it) and he scratched his cornea. He’s on medicated eye cream and looks much better.

Brownie, who had a broken tooth a few weeks back, has grown the tooth back but the four incisors are not meeting adequately. He goes back to the vet for another trim Monday. His weight is still way up, fortunately.

The other toothless pig Piglet had to go back in to the vet this past Monday to have her teeth trimmed again too. She has unfortunately stopped eating as many veggies, although she can now devour an orange slice right down to the rind with just her bottom incisors! She still picks at her alfalfa hay, but has plateaued at about 630g, which is far lower than I am happy with.

It was only three weeks between her first and second tooth trims. We have to make the decision about whether to extract her teeth by the time she’s due for her next trim. I’m going to be posting this question to GL to see whether anyone over there has any thoughts.

Pudge has made a surprisingly complete recovery from his skin condition. We still never got a real diagnosis or any firm confirmation on what caused this (nor on how we fixed it). Here’s a photo progression:

February 16: no symptoms yet. We took him to the vet for the initial hair loss just about a week later.

Pudge, 2/16/08

March 25: he had been sick for about a month and had almost complete hair loss on his sides and hindquarters.

Pudge, 3/25/08

April 3: Most of the original bald spots are showing hair regrowth, but he still had that scaly exudate covering patches on his back, butt, and cheeks. As that was removed (via scrubbing and medicated shampoos), those patches went bald.

Pudge, 4/3/08

Pudge, 4/3/08

Pudge, 4/3/08

April 23: Almost complete recovery, with just small thin spots. He does still have some scaly areas on his left cheek which I am working on. No apparent recurrence in the areas which have already healed.

Pudge, 4/23/08

Pudge, 4/23/08

I’m really not satisfied with not knowing what caused this, because it makes me feel like I can’t prevent a recurrence. But, as the prophet says, you can’t always get what you want.

We also did a very brief introduction between Pudge and Piglet. Unfortunately it didn’t go all that great. Pudge was more interested in defending the veggies from her perceived advances. Dummy. We’re going to keep trying – maybe once he realizes he’ll still have plenty of food, he’ll stop chattering at her.

04.18.08

Little Pig and her chinny-chin-chin

Posted in Day-to-day, Medical at 12:07 am by ACR&S

Three words (plus a conjunction) on the recent hiatus: taxes and kidney stones. What a week.


On Friday the 4th we got a call from our vet: could we possibly take in a special needs guinea pig? The owners brought her in for excessive drooling: an examination revealed she had no upper incisors – not just broken, but missing. She was supposedly three years old, but the owners could not afford the vetcare to treat or rehabilitate her, so they surrendered her. The vets and staff thought she was darling and couldn’t bear to just euthanize her.Even after seven years in rescue, you can still be shocked. Absolutely none of this made sense to me. How could she be totally missing her incisors? It can occur as a birth defect, for example in lethal whites, but if that was the case, how could she have made it to 3 years old with a non specialist owner and no previous vet care?

I went in expecting the vet to be wrong about the incisors, and the owner to be wrong about the age. Both were proven right.

PigletThis is the Piglet. She was originally named Cha-cha, which is too goofy even for me. We were going to call her Gummi Bear but that was sort of mean.

She’s incredibly underweight as the result of weeks or months of oral pain and difficulty – 608 grams on intake. Most of our sows are easily over 900, even the smaller ones. She’s very petite as well – easily fits in the palm of my hand. But she’s not just a dainty pig – you can feel the frailty that only comes with starvation.

Her nails do look like the nails of a 2-3 year old pig. She’s definitely not under a year old, which I would have guessed based on her size. I managed to talk to her owner – she had only ever eaten pellets, with occasional romaine and carrots, and vitamin C drops in the water. No hay, ever. She lived in a petstore cage, one of the medium-sized ones, with carefresh bedding. The owner confirmed that at one point she definitely did have upper incisors, this was not congenital.

No teefsThe veterinary exam showed the upper incisors to be missing, or at least, broken beneath the gumline. In this picture (taken after all her dental work) you can see a pink flap of supportive gum tissue which is normally behind the upper incisors. There was no sign of infection or swelling in the gums, and no obvious “holes”, all of which usually happens in broken teeth. Her lower incisors were so overgrown that her mouth could not close completely, and she had spurs and malocclusions on all her molar teeth, causing sores in her cheeks and tongue.

They sedated her to trim down the lowers and to plane the spurs off the molars. I asked them to also do an X-ray to verify whether the teeth were actually missing (including the roots) or just broken with an odd presentation. There are no roots. The teeth are actually completely missing.

You can also see in that picture that they shaved her chin, which was caked with dried saliva – she has a reverse goatee now.

According to Guinea Lynx, tooth loss can be caused by vitamin C deficiency. I think this is the most likely cause. The vitamin C in both water drops and in poor quality pellets degrades too quickly to provide adequate amounts like dietary C does. Occasional supplementation with romaine was simply not enough. C deficiency could also explain her small size; her growth overall was stunted.

Our primary goal was to put some weight on her. If we could keep her from dying of malnutrition, she might learn to eat without uppers and be able to live a fairly normal life, except for needing frequent trims on the lowers. We did assisted feeding using Critical Care, which Piglet took with gusto. She put on about 15 grams in the first two days; a very good sign that there was hope for her.

The next step was to see if she would eat at all on her own. Pigs who have lost their front teeth eventually learn to pull food into the mouth and chew it primarily with the molars. Could she learn to do this? We were also faced with the problem that she’d previously had a very limited diet; pigs tend to have neophobia about novel foods and it’s often difficult to tempt them into trying anything they aren’t familiar with or haven’t seen another pig eating.

Piglet’s dinnerSo twice a day, we feed her a large bowl of Critical Care mixed with applesauce, and a huge bowl of of greens cut into tiny 1/4″ pieces (she has shown a preference for romaine, kale, and fancy baby herb salad mix). She also gets a bowl with a variety of other fruits and veggies, cut up small, but all of them are hit or miss. She’s shown no interest in watermelon, apple, carrot or pepper; but loves tomatoes. Other greens like cilantro, basil, wheatgrass, and parsley have also been rejected. We continue to offer all of these veggies in rotation, just in case she changes her mind about any of them. She likes gumming a slice of orange, although mostly I think she’s licking at the juice rather than ingesting any of the pulp.

We’ve also been offering two types of hay, alfalfa and bluegrass. In her situation, the alfalfa is unlikely to do any damage. Fortunately, she loves it! She won’t eat the stems yet, but I crumple it up so all the tiny leaves fall off, and she eats them. I’m also offering the crumbles from the bottom of the bluegrass bag, which are short enough for her to eat, but I haven’t seen her making any great inroads into them.

Possibly because of the Critical Care, she has not shown much interest in her pellets, only eating one or two small pellets a day. The CC is much tastier and easier to gum. But in the nearly two weeks that we’ve had her, she’s gone from 608 g to 667. That’s an excellent recovery rate.

The next step, this weekend, will be to transition her from the Critical Care mash to a mash made with ground pellets. Once she’s eating the mashed pellets, it’s much more likely that she’ll eat the hard pellets as well – incisors are not used in pellet eating anyhow. We also need to keep assessing her for oral health; this diet is not the most conducive to normal tooth wear patterns. She goes back in Monday for a follow up dental and possibly re-trimming of her lower incisors.

We are also going to try to pair her with a companion in the coming days. I’m thinking about Pudgie, who is still arthritic, but who has recovered wonderfully from his bizarre skin condition. Pics of him will come next week!

04.08.08

Tips on hand feeding rabbits and guinea pigs

Posted in Husbandry How-to, Medical at 3:00 am by ACR&S

Guinea pigs and rabbits share a basic design flaw: a sensitive digestive system that reacts to stress and illness by shutting down (stasis), and which, once shut down, will kill the animal unless restarted.

It is critical that GP and rabbit owners know how to hand feed their animals. Hand feeding (also called syringe feeding or force-feeding) can be the life-or-death difference for an animal who is in stasis. It can also be a useful way to prevent stasis when you have an animal who is unwilling to eat for other reasons (pain, surgical recovery, etc).

Hand feeding can be VERY confusing, scary, and troublesome when you first do it. Later, it’s not so scary, and you find yourself making this huge production to prepare for it, but the feeding itself seems over in seconds.

You might find yourself more comfortable approaching hand feeding if you have specific tips to rely on. Guinea Lynx offers some excellent suggestions, especially with regards to amounts and transitioning back to regular food. But I wanted to offer some slightly more practical tips on the actual act of feeding itself:

Choose your product.
The two best options are Oxbow’s Critical Care (CC), or ground-up pellets (whatever your pet normally eats). I prefer the CC, only because it is MUCH easier to push through the syringe than pellets. The pellets don’t mix perfectly with the water, so the water gets pushed out and you end up with a syringe full of compressed pellet dust. However, on the negative side, some people report that an animal on long term assisted CC feeding will refuse to eat anything else once they’ve gotten addicted to CC. So for practical reasons, I use CC when I just have just one or two feedings to do (like nursing an animal post-surgery), but I do use a mix of CC and pellets, or alternate between them on different feedings, if I’ve got someone whose being fed 4x-daily for a week or more.

If you do choose to grind pellets, a cheap coffee grinder works wonders.

Preparing the slurry.
You’ll probably need to feed about 20 mL per feeding per kg of body weight, repeated between 2 and 4 times per day. Your vet will give you explicit instructions based on your pet’s weight. An animal who is eating a little on her own and is just getting a supplement to jump start her gut, probably only needs 1-2 feeds per day. So I prepare about 20 mL at a time, and throw away what I don’t use. A heaping 1/2 tablespoon of CC makes about 30 mL depending how much water you add.

You’ll need a spoon (for stirring and putting the slurry into the syringe), a small bowl (a shallow teacup works well because of the handle), and a 10 mL syringe.

Prepare the slurry by adding first the powder, then a warmed liquid – not hot, but slightly warm. You can use water, or Pedialyte, or cranberry or orange or apple juice. I typically use water for occasional feedings, Pedialyte for severely ill animals.

The directions on the CC aren’t very helpful. I think it recommends a 1:3 mix of powder to liquid, but this is usually pretty chunky, still. Too thick, and it’s hard to control when you push it through the syringe. Too wet, and the animal is getting more liquid than nutrition. I like my CC mix to be wet enough to be runny, but still form lumps when I drip a spoonful back into the bowl. Think thinish pancake batter. Brownie batter would be too thick.

When you’ve mixed your slurry, pull the plunger completely out of the syringe and hold the other part upright with your finger covering the pointy hole. Then use the spoon to drip slurry into the butt of the syringe till it’s full, then add the plunger. You’ll get some overflow at both top and bottom, but if you did it right, the syringe will be totally full and ready to go. If you get air bubbles, tapping the side of the syringe will move them upwards and you can expel them.

Set up the feeding station.
I find that I can do this best when the animal is about level with my shoulders, so I typically place the animal on the edge of a bed or table, and I sit on a low stool next to it. Sitting on the floor with the animal on the coffee table or couch might work too. The point is, you want to be able to curl your arm around the animal to help control her movements.

Be SURE you put a towel on the surface under the animal. Possibly several towels. She’s going to bitch and fight and slobber and shake her head and everything will be covered in flying CC. I also like to make a little wall of pillows around the towel (covered with more towels) so she can’t get away too easily. And you probably also want a spare towel for wiping up accidents or wiping the syringe on. And don’t wear nice clothing.

Feeding.
If you’re right handed, place the animal facing towards the right and sit facing towards her, turned slightly right yourself. Curl your left arm around her butt so that your left hand can have control of her shoulders and head, but if she backs up she is stopped by your arm and elbow. I typically keep my left hand on her head or back, patting her, unless I need to hold her still – then I keep my hand turned upright – thumb on top of the head, fingers curled around the cheek and under the jaw (hovering but not touching except to exert control if she tries to move). Keep her close to the edge so that she is close to your body, to prevent her from jumping off or turning around that way.

Take the syringe in your right hand and “start” it – get a small bubble of slurry ready on the tip. Approach her mouth from underneath – you want to touch the right corner of the bottom lip, rather than the nose or upper lip, so that the syringe slides behind her incisors – but keep the syringe mostly horizontal and aimed at her left cheek (if she’s facing 3 o’clock, you’re entering at 5 o’clock and aiming at 11 o’clock). Do NOT aim straight down the throat, animals have been known to aspirate on slurry.

Now the unpredictable part starts. She may grab the syringe and start sucking like a crack addict, or she may growl and whine and back up and box you, or she may duck her head and avoid the syringe, or she may bite it and not let go. To avoid all the negative things, you want to try to get in the mouth, push the plunger very gently and just a little, and get out quickly. Don’t try to give too much slurry at once – I give between .5 and 2 mL per jab (a line about 1-2 cm long), depending on the size of the animal, the plunger barely moves. Yes, it takes forever this way, but I once had an animal aspirate and I am not freaking risking it again. If you do it right, you should see her chewing – give her a moment to chew and swallow before you jab her again.

Another reason for the small mouthfuls is that if she gets too much, she’ll just spit it out and then you have an animal covered in brown drool. You can practice making small movements with the plunger to be sure you are able to jab in just the right amount and not too much. If she loves it, you may find she will just slurp it up in huge 5 mL mouthfuls, or even eats it from a spoon. If so, fantastic!

If she’s ducking her head or turning or backing away, you can use your left hand and arm to aim her at 3 o’clock again, but try to do it very gently. It’s hard to explain – you need to not be afraid of forcing her into position, but also don’t want to ACTUALLY force her if you can help it. Two fingers resting lightly on the jaw should be the maximum amount of force you actually need to exert. In between jabs, be sure to pet her head and nose and let her settle down if she’s very agitated.

Let the animal’s manner guide you on when it’s time to stop feeding. If she willingly takes a whole syringe, go ahead and make another one and start that. If she gets 5 mL or so and she starts to slow down and it gets harder and harder to get in there, push her as far as you can, but don’t do another 10 mL. You don’t want to make her hate the feedings, and you can always try again in a few hours.

If she’s eating willingly, it’s important to take advantage of her interest in food to offer her the opportunity to eat on her own. I often take a break between syringes and offer melon, wheatgrass, hay, etc; anything that might tempt her into eating on her own.

One last tip: get a GOOD scale, and weigh your pet both before and after every feeding. A steady pattern of weight loss, despite frequent and successful assisted feeding, indicates that you’re losing the battle. And you cannot see this without actually tracking the weights.

03.28.08

We laugh…

Posted in Humor, Medical, Philosophy at 1:55 am by ACR&S

… to keep from screaming. Sometimes a little off-color humor helps you make it through the rough patches.


Up in WI, the other day we found out that one of the local GL regulars just lost her last piggy. It was really sad; she’s a fantastic piggy mom and loved Blackberry like crazy. But she made a very generous donation of supplies to WIGPR, so Blackberry’s memory will live on with all the piggies her donation helps support.

Among the supplies was this thing:

Love my piggy

Part of me reeeeeeeally wants to keep it; the other part knows I do NOT need another dust collector in my house, especially one with crazy eyes that might come to life and start stalking me in the middle of the night. It’s going to have to go to the WIGPR with the rest of the stuff.


We’re taking in a sow from Char-Meck animal control this week. She’s obese, possibly ill, and has bumblefoot. But if we can get her healthy, she’ll be going to one of our great repeat adopters out in Asheville, which is about the best happy ending any piggy could ask for.

Apparently she’s so rotund that we might have to check her for pillbugs:

Potaytoe


Pudgie had a near-death experience on Tuesday. He seemed to be feeling much worse – dragging his hind legs and not really willing to move for his treats. We took him to the vet once again, fully expecting the vet to recommend euthanasia. But the vet didn’t feel like Pudge was ready to give up. Instead, we’re trying two more treatments – a new pain medication in addition to his Metacam, and a different topical shampoo to try and directly relieve his skin discomfort. So he got to come home after all.

He’s not as eager to move around as he was a week ago, but he’s definitely still got attitude and appetite – he didn’t want to get up to get his orange, so instead he whined and bitched at us till we put it right in his cuddle cup with him:

Preciouuuus


Finally, a note on Spring in Wisconsin. It’s pretty nasty. There’s no green growth yet, so everything’s grey and brown. The melting snow reveals a lot of ugliness and unpleasantness: dirt and garbage (the street sweepers can’t operate on ice), months-old frozen deer carcasses, ruts in the grass where cars ran off the road during snowstorms.

Among the worst things I’ve seen revealed by the snowmelt:

WTF

Yes, that’s a pissing toddler Brent Favre and a horrified toddler GB cheerleader. Seriously, Wisconsin, WTF.

03.25.08

Selamectin for parasite control in rabbits and guinea pigs

Posted in Medical at 12:07 am by ACR&S

One of the most commonly seen problems in guinea pigs is mites. According to Guinea Lynx, pigs can have mite infestations (Selnic mites, a type of mange mite specific to cavies) and not show any symptoms, because in healthy pigs the immune system keeps the infestation in check. But any stressor or illness can over-burden this symptom, leading to a sudden outbreak with no apparent cause. Rabbits don’t have the same predisposition towards endemic infestations, but since they are more often taken outside or allowed to come into contact with dogs and cats, they are more likely than pigs to have fleas.

From personal experience, I would say that about 100% of pet store pigs have mites. EVERY pet store pigs I have ever seen, which has not yet seen a vet, has had mites. This is without exception in nearly eight years of doing pig rescue. I had one poor pig surrendered because he “had a neurological problem”. Ten minutes with the pig, and I could see that he was merely scratching himself into seizures. I advised the owner that she could simply treat for mites and the problem would go away, but she declined because “the vet said pigs don’t get mites.” (This was a vet at the same PetSmart that sold her the pig. We took him in, treated him, and he recovered just fine.)

Due to both the available information and personal experience, I feel that both pigs and rabbits should be on regular preventative parasite treatment regimens, just like we do for dogs and cats. At ACR&S, every new animal is treated on intake. Resident animals are treated monthly (if there are frequent new animals coming in) or twice a year if there are not new animals coming in (like in the Sanctuary).

The standard parasite treatment for pigs and rabbits is Ivermectin. However, the drug acts on both parasites and the mammalian host in the same way: it blocks the GABA receptors. Because it has similar effects on host and parasite, there are numerous reports of toxicity due to overdose [1]. Despite these concerns, owners continue to be partial to Ivermectin because a) it’s available without a vet prescription, from locations such as farm stores, b) it’s very cheap, and c) it can be given orally, topically, or by injection.

At ACR&S, we have had success with using Revolution (generic name selamectin). It’s applied topically (to the back of the head or neck), only needs to be applied once per month, yet can be applied as often as every 2 weeks. It’s not commonly used by the GP and rabbit communities because a) it requires a vet prescription, and b) it’s expensive as heck (like $6-$12 per dose).

As evidenced by the similarity in names, selamectin is related to ivermectin, but its mechanism of action (binding the glutimate gated chloride channels) ONLY affects the parasite, and not the host [2]. Seemingly, this would make Revolution much safer than Ivermectin. Yet Guinea Lynx continues to maintain that Revolution does not have the proven safety record of Ivermectin. [3]

To verify this, I did some research and found a few articles which reference the use of selamectin in rabbits or guinea pigs (mostly rabbits).

Selamectin Safety and Efficacy Research

I actually found that selamectin has a very good record of safety, even using much higher doses (18 mg/kg and up) than are recommended by Pfizer and by vets:

1. Veterinary Dermatology 18(1) p.18-22, February 2007. 18 mg/kg used on 42 New Zealand rabbits with psoroptic mange and 37 Angora rabbits with sarcoptic mange. No adverse events and no mortality in either group. PDF

2. Journal of the American Veterinary Medical Association 223(3) p.322-324, August 2003. 48 mixed-breed domestic rabbits with active P cuniculi mite populations and clinical ear lesions. Both 6 mg/kg and 18 mg/kg were tested and deemed effective. No adverse reactions associated with selamectin treatment were observed in any group. PDF (not free).

3. Intern J Appl Res Vet Med Vol(3), p.87-96, 2007. Meta-analysis of other published studies. For Guinea pigs with any of 4 species of chewing lice or with the mange miter Trixacarus caviae: “Beck recommends 15 mg selamectin for animals weighing less than 800 g body weight and 30 mg for animals heavier than 800 g body weight.” For the fur mite Chirodiscoides caviae: “Good results in the treatment of this parasite have been achieved with 2 applications
of 12 mg/kg body weight selamectin with a 2-week interval. In a clinical case, a 3-year-old guinea pig with a body weight of 600 g was treated with a single topical application of 30 mg selamectin. Clinical signs improved within 1 week of treatment, and pruritus had ceased within a few days. There were no adverse effects following treatment.” PDF; I was not able to find the Beck article itself on Pubmed.

4. Material Data Safety Sheet from Pfizer. Tests in rats showed toxic effects on pregnant females and pups at 60 mg/kg/day. PDF

5. Product Profile for the European formulation, sold as Stronghold. “Selamectin has been classified as very slightly irritant to the rabbit skin and slightly irritant to the rabbit eye.” PDF.

Oddly I was not able to find many S&E studies on smaller doses, although that could be due to my search limitations (I don’t have access to vet-specific article databases). The MDSSs indicate that doses about double what these studies are looking at are problematic, at least in rats.

Since efficacy is clearly demonstrated at the lower dose of 6 mg/kg, and safety has been demonstrated for the higher dose of 18 mg/kg, I think it’s sensible to continue to use and recommend the lower dose of 6 mg/kg.

Dosage

First the disclaimer: I am not a vet. This information is not an acceptable replacement for a veterinary consultation, and you should never administer ANY medication without the supervision of your vet.

If you have spoken to your vet and you are both willing to use Revolution for parasite treatment in your guinea pig or rabbit, dosing takes two steps.

First, you need to weigh your animal on a very precise scale and convert the weight into metric (grams or kilograms). This is where the vet comes in: most vets have a gram scale, or at least have taken enough math that they can do the conversion.

Second, you need to figure out how much of the tube to apply, because the commercially available doses are too large for most guinea pigs or rabbits.

The recommended dose (from Pfizer and as from my research above) is 6 mg of selamectin per kg of animal body weight. The smallest size tube is the Kitten strength (Mauve package) which contains .25 mL of liquid containing 60 mg/mL of selamectin.

syringe.jpg60 mg per 1 mL = 6mg per.1 mL. So, an animal which weighs 1000 grams (1 kg) needs to have a dose of .1 mL. Since the tube contains .25 mL, it contains 2 and a half doses for this animal. To subdivide further, for every 100g of weight, add .01 mL (which is the tiniest marking interval on this syringe). So a 600g animal gets .06 mL, a 2300g animal gets .23 mL, a 985g animal gets .0985 mL (which you’ll probably measure out as either .09 or .1 mL, because you can’t actually get that fine a measurement with a syringe like this).

If you use any other package of Revolution, the strength in the tube might be different, and you will have to recalculate the dosage accordingly.

Application

The most appropriate way to dispense Revolution is to squeeze the whole tube out into a sterile container, then use a 1 mL syringe (above) to suck up the correct dose. If you do this, the container needs to have an air-tight cap, otherwise the unused portion will evaporate.

If you want to be less precise, one drop from the tube is approximately .1 mL. So, you can just squeeze out 1 drop per 100 grams. Use this method at your own risk.

If you’ve used a needle to pick up the Revolution, don’t inject it – just spread the fur on the back of the neck and drip it onto the skin. Taking the needle off to remove the chance of a stabbin’ is a good idea. Choose a spot high enough up the neck that the animal cannot reach it by turning her head around, but low enough that she can’t rub it with her front paws. If your animal lives with a friend, keep them separate for about 10-15 minutes, just long enough for it to dry. After that there’s no risk of them licking it off one another (although I’ve never seen that happen).

The liquid in the tube also contains isopropyl alcohol (rubbing alcohol). This is a known irritant to rabbits skin. In well over 300 uses of Revolution, the only adverse effects I’ve ever seen are that most rabbits will shake their heads and attempt to groom off the Revolution for several minutes after the alcohol has evaporated. I’ve never seen any associated redness, swelling, or other dermatitis. Irritable head-shaking and grooming in rabbits can probably be considered a normal reaction to administration, but if it persists more than an hour or is accompanied by dermatitis at the site, you need to see your vet ASAP.

If you are treating an active infestation, you can apply two doses 14 days apart. If you are treating preventively, one treatment a month is sufficient if you or your animal may come into contact with other animals or anything else that could reinfect your pet; once every six months otherwise.

Anecdotal Efficacy Reports

Although selamectin consistently performs well in clinical trials, there are reports from owners where mite infestations were not totally eradicated by selamectin. In fact – remember Pudge? We took him in for another vet check last week. The vet did another skin scraping, and this time, found a single fur mite. So now he feels that Pudge’s hair loss is due to a mite reaction, despite two recent applications of selamectin, and has prescribed oral ivermectin. This will be the first case in my personal experience where selamectin has not been effective, but it’s not an isolated case. I would still recommend selamectin as a first line attack, but where an symptoms seem to indicate a persistent infestation, a change in pharmacotherapy is certainly indicated.

Additional References

[1] Guinea Lynx. Accessed March 15, 2008.
[2] Ramesh Chandra Gupta. (2007) Veterinary Toxicology: Basic and Clinical Principles. Academic Press: Burlington, MA, p 511. Accessed via Google Book Search, March 15, 2008.
[3] Guinea Lynx. Accessed March 15, 2008.

03.04.08

Lymphosarcoma in Guinea Pigs

Posted in Medical at 4:17 am by ACR&S

The second medical crisis that we have in the Sanctuary doesn’t actually involve one of our Sanctuary pigs. My partner DKMS technically owns three of our 17 guinea pigs; we call these our “pet” pigs, and he, not ACR&S, pays for all of their care and supplies. Two were adopted from ACR&S and one from the WI Guinea Pig Rescue.

CinnamonCinnamon was rescued by ACR&S in 2006 from a local animal shelter. We already had a ton of young, adoptable pigs; she was estimated to be about 3 years old and was pretty scraggly looking, with rough-textured fur; so we didn’t think she’d be very adoptable, but we couldn’t leave her in the shelter. DKMS was looking for another friend for his pig Stinky and decided to adopt her almost immediately.

Cinnamon is probably 5 years old now, and this summer she developed some stiffness in her legs and would occasionally limp a few steps. An X-ray found that she had arthritis, so she was placed on a daily dose of Metacam for pain. It helped tremendously and she stopped limping; she also loves her medicine and fights to hold onto the syringe!

On Feb 19, when giving Cinnamon her medication, we noticed that she looked a little “off”. She wasn’t moving as much or as normally as usual. I picked her up and found that she was COVERED in large, hard nodules – under her throat and jaw, and beneath each leg. They literally sprang up within 24 hours. These are the locations of the lymph nodes, so our first fear was a severe infection, and we rushed her to the vet for antibiotics. The vet placed her on antibiotics, but also did a biopsy to confirm, and a few days later we had the results: lymphosarcoma.

Background & Incidence

Lymphosarcoma is a malignant cancer involving lymphatic tissue or lymphocytes. The lymph nodes produce lymphocytes, which are white blood cells that help the body protect itself from infection. Lymphosarcoma occurs when the lymphocytes undergo a malignant change and begin to multiply, eventually crowding out healthy cells and creating tumors in the lymph nodes or other parts of the immune system. [1] Lymphomas and lymphosarcomas are much better understood in humans, and divided in to a huge number of sub-classifications based on location and type of affected cells. The same sub-classifications could probably be made in animals as well, but the disease(s) are not as well studied as in humans.

The small number of scientific articles I have found on lymphosarcoma don’t give much information, but it’s reported as very rare. One case report from 2000 notes that there were only 15 cases out of 5,000 animals in a 1991 report. [2] A 2003 paper states “neoplasias are practically non-existent in animals less than 1 year of age (Wagner and Manning 1976). In animals surviving three years the frequency of tumours is as high as 15% (Blumenthal and Rogers 1965). In some laboratory strains, animals older than three years, had tumour incidence ranging from 14.4% to 30% (Wagner and Manning 1976).” [3] Note the age of all of these source articles! And yet, these data contradict the owner anecdotes and some veterinary teaching information, both of which seem to indicate lymphosarcoma occurs fairly commonly, at least in older pigs.

Symptoms

Symptoms can vary, primarily by the location and type of lymphosarcoma. The most obvious symptom is usually swollen or enlarged lymph nodes, but owner anecdotes from medical threads on Guinea Lynx include include loose stools, loss of appetite, weight loss, difficulty breathing, and increased thirst or urination. [4] In some cases, owners went to the vet for one of these secondary symptoms, and the enlarged lymph nodes were only discovered during the physical examination by the vet.

Treatment & Prognosis

Treatments in dogs and cats (and humans) can include chemotherapy. In a guinea pig, chemotherapy is not as well studied; protocols are not established based on large-sample trials, and their small size makes it difficult since the drugs are designed for larger species. However, it has been done, and there are drug protocols for chemo available on Guinea Lynx.

Due to Cinnamon’s age, her vet did not feel that she would have a positive response to chemo. It causes nausea and GI upset, and she would be likely to go into GI stasis; it also works by suppressing immune function, making her more susceptible to opportunistic infections. He instead suggested that we keep her on pain medication, and also put her on Prednisone. Prednisone is said to shrink the tumors, or at least to slow their growth. As a steroid, it also reduces inflammation and pain.

Most of the treatment information on lymphosarcoma in guinea pigs comes from anecdotal reports of owners who have been through the disease with their pet. However, the prognosis is almost universally bad. One well-respected poster reports: “The average survival rate is quite variable, but I have yet to hear of one living longer than 6 weeks.” [5] Even when the pig is on Prednisone, a commonly reported complication is the tumors in the throat lymph nodes pressing on the trachea or esophagus, making eating and breathing difficult.

Given the information we have found, we do not expect Cinnamon to be with us very much longer. So now we are mostly focusing on making her comfortable and her last days enjoyable. She is still housed with her friend Stinky, who cuddles up with her and has been seen grooming her ears. She’s been a wonderful little girl and we’ll be very sorry to see her leave us.

02.29.08

A Goodbye to Thor; and A Medical Mystery

Posted in Medical, Memorials at 1:20 am by ACR&S

ThorWe’ve had a busy couple of weeks at the Sanctuary, so we’re not yet ready to show you the pictures I’ve been promising.

About two weeks ago, we lost Thor, our oldest Sanctuary pig. Thor was one of the first four pigs ever rescued by ACR&S. In Summer 2001, the Orange County APS had seized 13 pigs which were being sold out of a trash can at a flea market. Some had broken legs, others had bite injuries or skin infections, and most were ill. They were rescued, neutered, and placed up for adoption through APS.

After about half of the thirteen were adopted, APS contacted ACR&S and asked if we could take the remaining six or seven. At the time we did not have a foster setup to allow for such a large surrender, but we promised that we’d make arrangements, and if any were left at APS after one month, we would take them. Four pigs were left, and we named them Freya, Odin, Loki, and Thor.

Time took its natural course with Freya, Odin, and Loki; and for the last two years Thor has lived alone with another elderly boar, Brownie. Thor was found dead in his cage on the morning of February 17, 2008. He had shown no signs of acute illness and was his normal elderly self on the previous evening. We estimate he was about 7 and a half years old. Goodbye, little fighter – I miss you.


There are two more health crises ongoing in the Sanctuary. The first is our poor boy Pudge.

History and Symptoms
Pudge is a 7 or 8 year old neutered boar who came to us from a divorcing foster parent in 2005. We had known him since 2003 and he was probably 2-3 years old at that time.PudgeIn the first two weeks of February, Pudge developed some weakness in his hind legs. He was also barbering the fur on his knees, a sign he was uncomfortable. We put him on Metacam for pain, and a vet visit and X-ray confirmed fairly severe arthritis in both hips. PudgeBetween February 21 and February 24, he continued barbering and scratching himself to the point that parts of his sides are totally denuded. The skin is irritated and swollen; compare the picture above to this one:

However, his appetite and fecal output are both normal and he is maintaining weight.

Differential Diagnosis and Treatments
Typically, displacement activity like barbering and scratching is seen in animals who are in severe pain. Sows with ovarian cysts and pigs with bladder stones or arthritis often barber their legs and sides, trying to attack a pain they cannot reach. The vet re-reviewed the X-rays and confirmed that there were no stones or obvious masses or spinal injury that could be causing a more severe pain than predicted from the arthritis diagnosis. So we have to treat the pain directly until we know what’s causing it: Pudge was already on Metacam, but we increased the dose to .75mL twice per day. He seems somewhat more comfortable.

However, the extent of scratching and skin irritation Pudge displays is usually a sign of severe mite infection. The Sanctuary residents get regular preventative mite treatment (Revolution), the last treatment was only about 2 months ago, and we haven’t had any un-treated animals come in. It’s possible that one of the human caretakers was a vector but this is fairly unlikely. Regardless, we repeated Pudge’s Revolution treatment on 2/26 just in case. We have also changed his bedding (from wood shavings to Carefresh), and put him on an antihistamines, just in case this is some sort of allergic reaction (and to make him more comfortable). He’s definitely not scratching as much but we don’t yet know which treatment is helping more.

Joint pain, and hair loss/skin sensitivity, are two of the symptoms of scurvy. We feed a diet rich in Vitamin C, but it is possible that at his advanced age, Pudge is losing his ability to process nutrients effectively, and has not been getting enough. This is an unlikely diagnosis, because he shows no anorexia or diarrhea, which typically accompany scurvy. However, extra Vitamin C can also strengthen the system of a pig in any illness situation, so we are giving liquid C by subcue injection once per day. We are also increasing his dietary C to over 100mg per day via extra oranges and green peppers. He is going through the extra veggies like a buzzsaw; appetite is certainly not a problem!

Pudge’s vets are mystified but he’s a little trooper and I’m hopeful that we can pull him through this. At the very least, we know that we have done everything possible to make him comfortable. Right now, he’s snoozing in his cuddle cup with no obvious signs of distress. I’ll post an update when we see a change one way or the other.


Next Tuesday, I’ll discuss our second medical crisis: Lymphosarcoma in guinea pigs. And Friday, at long last, pictures of the Sanctuary and of the Plush Pet Adoption Kits!

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